Ibutilide therapy for atrial fibrillation: 5-year experience in a community hospital.
Many institutions restrict the use of ibutilide because of the potential risk of polymorphic ventricular tachycardia (PMVT). Over a 5-year period from June 2000 to May 2005, 238 patients, 151 men and 87 women, with a mean age of 67.1 years (range, 22-94 years), received intravenous ibutilide at our institution. Ibutilide was administered by nurses or physicians in 4 clinical settings: emergency department (n = 80), intensive care unit (n = 11), patient room on telemetry (n = 107), and in the cardiac catheterization/electrophysiology laboratory (n = 40). Conversion to sinus rhythm occurred in 59% of patients outside the catheterization/electrophysiology laboratory. The incidence of PMVT was 1.7%. Three patients had brief nonsustained PMVT and 1 patient had a sustained PMVT. There was no difference in outcome whether a physician was present at the time of ibutilide administration. Our data suggest that ibutilide is a safe and efficacious drug when ordered by experienced physicians in properly selected patients in a variety of monitored settings.
Giudici
Michael C
MC
Cardiology Department, Genesis Heart Institute, Davenport, Iowa 52803, USA. fondomg@yahoo.com
Fischer
William J
WJ
Cervantes
David C
DC
Schrumpf
Phillip E
PE
Paul
Deborah L
DL
Sentman
Kristin E
KE
Serra
Victoria L
VL
Barold
S Serge
SS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy* / Q000451:nursing; D016903:Drug Monitoring; D004562:Electrocardiography; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D017009:Professional Autonomy; D012189:Retrospective Studies; D012307:Risk Factors; D012449:Safety; D013449:Sulfonamides / Q000009:adverse effects / Q000627:therapeutic use*; D016171:Torsades de Pointes / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
D000889:Anti-Arrhythmia Agents; D013449:Sulfonamides; C067192:ibutilide